Potassium-competitive acid blocker has more negative impacts on clinical outcomes in patients with non-small cell lung cancer treated with checkpoint inhibitors than those of proton pump inhibitors.
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引用次数: 0
Abstract
Background: Proton pump inhibitors (PPIs) are well-known inducers of gut dysbiosis because oral bacteria cannot be sterilized owing to their gastric acid-suppressing effect. PPI-induced gut dysbiosis is associated with shorter progression-free survival (PFS) and overall survival (OS) in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs). Although vonoprazan exhibits more powerful acid suppression than PPIs, its effect on ICI therapy outcomes remains unknown. We evaluated vonoprazan on ICI therapy efficacy in patients with NSCLC.
Methods: This retrospective study included patients aged ≥ 18 years with advanced or recurrent NSCLC receiving ICI monotherapy or ICI plus chemotherapy between January 2016 and December 2021 at Osaka Metropolitan University Hospital.
Results: Of the 289 patients, 121 received PPIs, 22 received vonoprazan, and 146 did not receive either vonoprazan or PPIs (control group). In multivariate analysis, the PFS in the PPI (hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.21-2.21; p = 0.0014) and vonoprazan groups (HR, 2.49; 95% CI, 1.47-4.23; p < 0.001) were significantly shorter than those in the control group. The OS in the PPI (HR, 1.74; 95% CI, 1.23-2.45; p = 0.0017) and vonoprazan groups (HR, 5.24; 95% CI, 2.88-9.53; p < 0.001) were also significantly shorter than those in the control group.
Conclusion: Vonoprazan was associated with worse PFS and OS in patients with NSCLC treated with ICIs than those who did not receive PPIs or vonoprazan. Moreover, vonoprazan may have a more negative impact on ICI therapy efficacy than PPI.
期刊介绍：
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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